(132) A Surprising Side Effect: IUD Placement Restores Vaginal Orgasm

Abstract Introduction Postpartum sexual dysfunction is a prevalent and multifactorial issue with biological, psychological and relational dimensions, but is frequently under-recognized and under-treated in clinical practice. One possible anatomic cause of postpartum sexual dysfunction is cervical pathology – such as adhesions or stenosis– that can arise after obstetric or gynecologic procedures and could possibly contribute to symptoms like anorgasmia or dyspareunia. Intact genital anatomy may contribute to the presence or absence of vaginal orgasms, specifically. While vaginal orgasms are believed to only occur in a small portion of the female population, they may be associated with the complex innervation to the cervix from branches of the pelvic, hypogastric, and vagus nerves. Therefore, the disruption of normal cervical tissue may be linked to altered sexual sensation and orgasmic function. Given the high prevalence of postpartum sexual dysfunction, and the potential for cervical adhesions to disrupt normal sexual response, this novel case highlights a key gap in the current understanding of postpartum sexual health. Objective This is a case report of an individual with a history of postpartum anorgasmia, who re-developed vaginal orgasms after placement of an intra-uterine device (IUD) and mitigation of cervical stenosis and intra-cervical adhesions (ICA). Methods The patient was a 44 year old peri-menopausal woman who presented to a sexual medicine clinic for management and treatment of peri-menopause, muted clitoral orgasms, and absent vaginal orgasms following childbirth at age 39. She has a notable history for two dilation and curettage (D&C) procedures following childbirth. Despite these treatments and a lysis of clitoral adhesions procedure in 2021, she was still unable to vaginally orgasm. In the fall of 2024 (at age 48) she presented to her gynecologist for the placement of an IUD for better management of menstrual bleeding. During the procedure, the gynecologist noted ICA, and required multiple dilators to identify the cervical os, delineate cervical contours, and mitigate the ICA. Results The patient followed-up at the sexual medicine clinic in the fall of 2025. She reported a complete return of “internal” orgasms, and noted that deep penetration resulted in full-body orgasm nearly every time she had intercourse. She explained that this change occurred within weeks of receiving cervical dilation and placement of the IUD the previous year. Conclusions The unique case presented highlights the first instance connecting the treatment of cervical stenosis and adhesion to vaginally-induced orgasm. Although intra-uterine adhesions are widely reported as sequelae following D&C after childbirth, there is no research on anorgasmia as a possible sequela. Furthermore, while IUD is currently the gold standard intervention for preventing intrauterine adhesions, its use in preventing and treating ICA is not fully understood. Disclosure No.